Provider Demographics
NPI:1437991577
Name:GAGNON, JASMINE (NP-C)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:GAGNON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1157
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-1157
Mailing Address - Country:US
Mailing Address - Phone:406-529-2518
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1157
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834-1157
Practice Address - Country:US
Practice Address - Phone:406-529-2518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT239466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily